Individual
DR. DON J WAGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
605 E 7TH ST, BURLINGTON, IN 46915-9441
(765) 566-3351
(765) 566-2250
Mailing address
PO BOX 38, 605 E. 7TH ST., BURLINGTON, IN 46915-0038
(765) 566-3351
(765) 566-2250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01019897
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100135360B
—
IN
Enumeration date
01/20/2006
Last updated
05/15/2009
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